Individual
SHAWQWEISHA GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
800 EUGENE ST, YPSILANTI, MI 48198-6147
(734) 796-6339
Mailing address
800 EUGENE ST, YPSILANTI, MI 48198-6147
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703129929
MI
Other
Enumeration date
06/18/2025
Last updated
06/18/2025
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